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Questions and Answers
Which of the following correctly defines cardiovascular disease (CVD)?
Which of the following correctly defines cardiovascular disease (CVD)?
What is one of the major types of cardiovascular disease?
What is one of the major types of cardiovascular disease?
How many hospital admissions are attributed to heart attacks each year in the UK?
How many hospital admissions are attributed to heart attacks each year in the UK?
What is a significant health risk factor for cardiovascular disease?
What is a significant health risk factor for cardiovascular disease?
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What is the total annual healthcare cost of cardiovascular disease in the UK?
What is the total annual healthcare cost of cardiovascular disease in the UK?
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Which of the following conditions is considered cerebrovascular disease?
Which of the following conditions is considered cerebrovascular disease?
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What is one way cardiovascular disease can affect patient management?
What is one way cardiovascular disease can affect patient management?
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What is the primary type of cardiovascular disease involving blood vessel issues in the legs?
What is the primary type of cardiovascular disease involving blood vessel issues in the legs?
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Which of the following is a lifestyle risk factor for cardiovascular disease?
Which of the following is a lifestyle risk factor for cardiovascular disease?
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What is the first stage of atherosclerosis?
What is the first stage of atherosclerosis?
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Which complication is associated with thrombosis in atherosclerosis?
Which complication is associated with thrombosis in atherosclerosis?
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What is angina pectoris primarily caused by?
What is angina pectoris primarily caused by?
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Which of the following is NOT considered a risk factor for ischaemic heart disease?
Which of the following is NOT considered a risk factor for ischaemic heart disease?
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What characterizes stable angina?
What characterizes stable angina?
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Which of the following medications is primarily used for the management of angina pectoris?
Which of the following medications is primarily used for the management of angina pectoris?
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Which factor is most directly linked to the formation of plaques in atherosclerosis?
Which factor is most directly linked to the formation of plaques in atherosclerosis?
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What is the primary result of a myocardial infarction?
What is the primary result of a myocardial infarction?
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High cholesterol levels are associated with which of the following conditions?
High cholesterol levels are associated with which of the following conditions?
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What is a common symptom of myocardial infarction?
What is a common symptom of myocardial infarction?
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Which of the following is NOT a typical symptom of myocardial infarction?
Which of the following is NOT a typical symptom of myocardial infarction?
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What immediate step should be taken if a patient is suspected of having a myocardial infarction?
What immediate step should be taken if a patient is suspected of having a myocardial infarction?
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Which treatment is appropriate for a patient experiencing a myocardial infarction?
Which treatment is appropriate for a patient experiencing a myocardial infarction?
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What is a potential complication following a myocardial infarction?
What is a potential complication following a myocardial infarction?
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What is the primary concern during cardiac arrest?
What is the primary concern during cardiac arrest?
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Which event may frequently trigger cardiac arrest?
Which event may frequently trigger cardiac arrest?
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What treatment can be administered if a patient is in ventricular fibrillation?
What treatment can be administered if a patient is in ventricular fibrillation?
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Which complication may occur later, after a myocardial infarction?
Which complication may occur later, after a myocardial infarction?
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What could be a consequence of cerebral hypoxia due to cardiac arrest?
What could be a consequence of cerebral hypoxia due to cardiac arrest?
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Study Notes
Cardiovascular Disease
- Cardiovascular disease is a group of disorders affecting the heart and blood vessels.
- UK Statistics: 7.6 million people live with cardiovascular disease, resulting in 450 deaths daily, 100,000 hospital admissions annually due to heart attacks, a stroke every 5 minutes, and a total annual healthcare cost of £9 billion.
- Types of cardiovascular disease: coronary heart disease, cerebrovascular disease, peripheral vascular disease, deep vein thrombosis and pulmonary embolism, valvular heart disease, and congenital heart disease.
Risk Factors
- Lifestyle risk factors: unhealthy diet (high in salt), physical inactivity, obesity, smoking, alcohol.
- Other risk factors: hypertension, high cholesterol, diabetes, kidney disease, age, gender, ethnicity, family history.
Atherosclerosis
- Atherosclerosis is the common disorder underlying cardiovascular disease.
- Causes: Narrowing of arteries due to a buildup of plaques (atheroma), limiting oxygen-rich blood flow to organs.
- Mechanism: Damage to the endothelium of the artery triggers a chronic inflammatory response.
Stages of Atherosclerosis
- Endothelial injury or dysfunction.
- Fatty streak: lipids accumulate beneath the damaged endothelium.
- Inflammatory response: recruitment of white blood cells and foam cell formation.
- Plaque progression: migration of smooth muscle cells, increased connective tissue, calcification, platelet adhesion, and fibrous cap formation.
- Plaque disruption.
Atherosclerosis - Risk factors
- Physical stress on arteries: turbulent flow, for example, where arteries branch.
- Smoking/air pollution: circulation of reactive oxygen radicals.
- Dyslipidaemia: high total cholesterol, high LDLs, low HDLs.
- Chronically elevated blood glucose levels.
Atherosclerosis - Complications
- Thrombosis: blockage of the artery.
- Infarction: tissue death due to impaired blood flow.
- Embolus: travels in the bloodstream to a coronary artery or artery supplying the brain.
- Ischaemic heart disease, Angina, Myocardial infarction (heart attack), Cerebrovascular disease (stroke), Aneurysm, Peripheral vascular disease.
Ischaemic Heart Disease
- Ischaemia: restriction of blood supply to tissues.
- Ischaemic (coronary) heart disease: due to atherosclerosis and hypertension.
- Leads to: Angina pectoris and myocardial infarction.
- Infarction: can lead to acute circulatory failure, loss of cerebral blood supply, and death.
- Risk factors: age, smoking, hyperlipidaemia, diabetes, hypertension.
Hyperlipidaemia
- High blood cholesterol can be familial and associated with age, gender, inactivity, being overweight, low dietary fibre, smoking, ethnicity, low socioeconomic status, and other diseases (hypertension, diabetes, andchronic kidney disease).
- Management: lower LDL levels and raise HDL levels through lifestyle modifications and statins.
Angina Pectoris
- Severe chest pain caused by narrowing of the coronary arteries.
- Associated with: increased blood lactic acid.
- Symptoms: squeezing, crushing, gripping substernal pain (may radiate to left arm/jaw).
- Types: stable or unstable.
Angina Pectoris - Management
- Relief: rest or glyceryl trinitrate (GTN) medication, which stimulates vasodilation.
- Pain resolution: within 2-3 minutes.
- Other medications: Aspirin, calcium channel blockers, beta blockers, ACE inhibitors, statins.
- Angioplasty or surgery: stents or a coronary artery bypass graft may be required.
Myocardial Infarction (Heart Attack)
- Sudden injury caused by blockage of a coronary artery.
- Mechanism: rupture of a vulnerable atheromatous plaque.
- Resultant ischaemia: oxygen shortage leads to necrosis (tissue death) of the myocardium.
Myocardial Infarction - Clinical Presentation
- Severe, central crushing pain radiating to the left arm or jaw.
- May start at rest and persist.
- Symptoms: restlessness, facial pallor, sweating, nausea, vomiting, confusion, and apprehension.
- Silent infarctions: 10-20% of patients have no pain.
- Atypical symptoms: women may present with atypical symptoms.
- Death: can occur soon after onset of chest pain due to ventricular fibrillation and cardiac arrest.
Myocardial Infarction - Management
- Call 999 for emergency assistance.
- Immediate hospital admission for: ECG, blood tests, echocardiogram, oxygen, thrombolytic therapy, analgesics, anticoagulants, ACE inhibitors, sedative, bed rest, surgery.
- Comfortable position: GTN spray if known angina, dispersible aspirin 300mg chewed (unless clear evidence of allergy to it), oxygen if patient hypoxaemic, monitor and be prepared to start CPR/AED.
Myocardial Infarction - Complications
- Outlook: depends on onset to treatment.
- Acute complications: cardiac dysrhythmias, cardiac failure, and pericarditis.
- Later complications: angina, thromboembolism, aneurysm, cardiac rupture.
- Longer-term complications: post-MI syndrome (Dressler's syndrome), shoulder-hand syndrome, psychological problems, and depression.
Cardiac Arrest
- Serious and catastrophic event.
- Causes: abrupt loss of heart function, breathing, and consciousness.
- Mechanism: electrical malfunction where the heart stops beating preventing oxygen-rich blood from being pumped to the brain, lungs, and other organs.
- May occur after myocardial infarction but often has other causes.
Cardiac Arrest - Consequences
- Cerebral hypoxia: causes respiratory arrest and brain injury.
- Survivors may have: personality changes, memory and speech impairment, involuntary movements, and incontinence.
Cardiac Arrest - Management
- Chain of survival: CPR to provide circulatory support, AED if a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia) is present.
Maintaining Emergency Knowledge
- To care for patients in an emergency, dental professionals must maintain a high level of emergency knowledge.
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Description
This quiz covers the key aspects of cardiovascular disease, including its types, risk factors, and statistics. It highlights the impact of lifestyle choices and underlying conditions such as atherosclerosis. Test your knowledge on this critical health topic.
